Bed Making

JC Helen Shaji

Section 1

1Basic Nursing Care Procedures

Bed Making
Checking Vital Signs
Performing Hygienic Procedures and Other Basic Procedures
Specimen Collection
Administration of Medications

Bed MakingChapter 1

MAKING AN UNOCCUPIED BED

Definition

A bed prepared to receive a new patient is an unoccupied bed.

Purposes

To provide clean and comfortable bed for the patient.
To reduce the risk of infection by maintaining a clean environment.
To prevent bed sores by ensuring that there are no wrinkles to cause pressure points.

Equipments Required

Mattress: 1
Bed sheets: 2
- Bottom sheet: 1
- Top sheet: 1.
Pillow: 1
Pillow cover: 1
Mackintosh: 1
Draw sheet: 1
Blanket: 1
Savlon water or Dettol water in basin
Sponge cloth: 4
- To wipe with solution: 1
- To dry: 1
- When bed making is done by two nurses, sponge cloth is needed two each.
Kidney tray or paper bag: 1
Laundry bag or hamper bag: 1
Trolley: 1.

Procedure

Bed making procedure is detailed in Table 1.1.4

Table 1.1 Bed making procedure

SI No	Care action	Rationale
1.	Explain the purpose and procedure to the client	Providing information fosters cooperation
2.	Perform hand hygiene	To prevent the spread of infection
3.	Prepare all required equipments and bring the articles to the bedside	Organization facilitates accurate skill performance
4.	Move the chair and bedside locker	It makes space for bed making and helps effective action
5.	Clean the bedside locker: Wipe with wet and dry	To maintain the cleanliness
6.	Clean the mattress: Stand in right side Start wet wiping from top to center and from center to bottom in right side of mattress Gather the dust and debris to the bottom Collect them into kidney tray Give dry wiping as same as procedure 2 Move to left side Wipe with wet and dry the left side Move to right side	To prevent the spread of infection
7.	Bottom sheet: Place and slide the bottom sheet upward over the top of the bed leaving the bottom edge of the sheet Open it lengthwise with the center fold along the bed center Fold back the upper layer of the sheet toward the opposite side of the bed Tuck the bottom sheet securely under the head of the mattress (approximately 20–30 cm) Make a mitered corner: Pick up the selvage edge with your hand nearest to the hand of the bed Lay a triangle over the side of the bed Tuck the hanging part of the sheet under the mattress Drop the triangle over the side of the bed Tuck the sheet under the entire side of bed Repeat the same procedure at the end of the corner of the bed Tuck the remainder in along the side	Unfolding the sheet in this manner allows you to make the bed on one side A mitered corner has a neat appearance and keeps the sheet securely under the mattress Tucking the bottom sheet will be done by turning the corner of top first and the corner of the bottom later To secure the bottom sheet on one side of the bed
8.	Mackintosh and draw sheet: Place a mackintosh at the middle of the bed (if used), folded half, with the fold in the center of the bed Lift the right half and spread it forward to the near side Tuck the mackintosh under the mattress Place the draw sheet on the mackintosh Spread and tuck as same as procedure 1–3 Move to the left side of the bed	Mackintosh and draw sheet are additional protection for the bed, and serves as a lifting or turning sheet for an immobile client
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9.	Bottom sheet, mackintosh and draw sheet: Fold and tuck the bottom sheet as in the above procedure 7 Fold and tuck both the mackintosh and the draw sheet under the mattress, as given in the above procedure 8 Return to the right side	Secure the bottom sheet, mackintosh; and draw the bottom sheet, mackintosh and draw sheet
10.	Top sheet and blanket: Place the top sheet evenly on the bed, centering it in the below 20–30 cm from the top of the mattress Spread it downward Cover the top sheet with blanket in the below 1 foot from the top of the mattress and spread downward Fold the cuff (approximately 1 foot) in the neck Tuck all these together under the bottom of mattress; miter the corner Tuck the remainder in along the side	A blanket provides warmth Making the cuff at the neck part prevents irritation from blanket edge Tucking all these pieces together saves time and provides a neat appearance To save time in this manner
11.	Repeat the same as in procedure 10 for the left side Return to the right side
12.	Pillow and pillow cover: Put a clean pillow cover on the pillow Place a pillow at the top of the bed in the center with the open end away from the door	A pillow is a comfortable measure Pillow cover keeps cleanliness of the pillow and neat The open end may collect dust or organisms The open end away from the door is also maintained neat
13.	Return the bed, chair and bedside table to their proper place	Bedside necessities will be within easy reach for the client
14.	Replace all equipments in proper place	It makes well-setting for the next procedure
15.	Discard lines appropriately	Proper linen disposal prevents the spread of infection
16.	Perform hand hygiene	To prevent the spread of infection

Nursing Alert

Do not let your uniform touch the bed and the floor not to contaminate yourself.
Never throw soiled linens on the floor not to contaminate the floor.
Staying one side of the bed until one step is completed, save steps and time to do effectively.

CHANGING AN OCCUPIED BED

Definition

The procedure of changing used linens of a hospitalized patient is an occupied bed. 6

Purposes

To provide clean and comfortable bed for the patient.
To reduce the risk of infection by maintaining a clean environment.
To prevent bed sores by ensuring that there are no wrinkles to cause pressure points.

Equipments Required

Bed sheets: 2
- Bottom sheet (or bed cover): 1
- Top sheet: 1.
Draw sheet: 1
Mackintosh: 1 (if contaminated or needed to change)
Blanket: 1 (if contaminated or needed to change)
Pillow cover: 1
Savlon water or Dettol water in bucket
Sponge cloth: 2
- To wipe with solution: 1
- To dry: 1
- When the procedure is done by two nurses, sponge cloth is needed two each.
Kidney tray or paper bag: 1
Laundry bag or bucket:1
Trolley: 1.

Procedure

Procedure for changing an occupied bed is detailed in Table 1.2.

Table 1.2 Procedure for changing an occupied bed

Sl No	Care action	Rationale
1.	Check the client's identification and condition	To assess necessity and sufficient condition
2.	Explain the purpose and procedure to the client	Providing information fosters cooperation
3.	Perform hand hygiene	To prevent the spread of infection
4.	Prepare all required equipments and bring the articles to the bedside	Organization facilitates accurate skill performance
5.	Close the curtain or door of the room; put screen	To maintain the client's privacy
6.	Remove the client's personal belongings from bedside and put them into the bedside locker or in safe place	To prevent personal belongings from damage and loss
7.	Lift the client's head and move pillow from center to the left side	Pillow is a comfortable measure for the client
8.	Assist the client to turn toward left side of the bed; adjust the pillow and leave top sheet in place	Moving the client as close to the other side of the bed as possible, which give more room to make the bed
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		Top sheet keeps the client warm and protect his/her privacy
9.	Stand in right side; loose bottom bed linen and fanfold (or roll) soiled linens from the side of the bed and wedge them close to the client	Placing folded (or rolled) soiled linen close to the client allows more space to place the clean bottom sheets
10.	Wipe the surface of mattress by sponge cloth with wet and dry	To prevent the spread of infection
11.	Bottom sheet, mackintosh and draw sheet: Place the clean bottom sheet evenly on the bed, folded lengthwise with the center fold as close to the client's back as possible Adjust and tuck the sheet tightly under the head of the mattress, making mitered the upper corner Tighten the sheet under the end of the mattress making mitered the lower corner Tuck in alongside Place the mackintosh and the draw sheet on the bottom sheet and tuck in them together	Soiled linens can easily be removed and clean linens are positioned to make the other side of the bed
12.	Assist the client to roll over the folded (rolled) linen to right side of the bed; readjust the pillow and top sheet	Moving the client to the bed's other side allows to make the bed on that side
13.	Move to left side; discard the soiled linens appropriately; hold them away from the uniform and place them in the laundry bag (or bucket)	Soiled linens can contaminate the uniform, which may come into contact with other clients
14.	Wipe the surface of the mattress by sponge cloth with wet and dry	To prevent the spread of infection
15.	Bottom sheet, mackintosh and draw sheet: Grasp clean linens and gently pull them out from under the client Spread them over the bed's unmade side; pull the linens taut Tuck the bottom sheet tightly under the head of the mattress and miter the corner Tighten the sheet under the end of the mattress and make mitered the lower corner Tuck in alongside Tuck the mackintosh and the draw sheet under the mattress	Wrinkled linens can cause skin irritation
16.	Assist the client back to the center of the bed; adjust the pillow	Pillow is a comfort measure for the client
17.	Return to right side: Clean the top sheet, blanket Place the clean top sheet at the top side of the soiled top sheet	Tucking these pieces together saves time and provides neat, tight corners
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	Ask the client to hold the upper edge of the clean top sheet Hold both the top of the soiled sheet and the end of the clean sheet with right hand and withdraw to downward; remove the soiled top sheet and put it into a laundry bag (or a bucket) Place the blanket over the top sheet; fold top sheet back over the blanket over the client Tuck the lower ends securely under the mattress; miter corners After finishing the right side, repeat for the left side
18.	Remove the pillow, replace the pillow cover with clean one and reposition the pillow to the bed under the client's head	Pillow is a comfortable measure for the client
19.	Replace personal belongings back; return the bedside locker and the bed as usual	To prevent personal belongings from loss and provide safe surroundings
20.	Return all equipments to proper place	To prepare for the next procedure
21.	Discard linens appropriately; perform hand hygiene	To prevent the spread of infection

MAKING A POSTOPERATIVE BED

Definition

Postoperative bed is a special bed prepared to receive and take care of a patient returning from surgery.

Purposes

To receive the postoperative client from surgery and transfer him/her from a stretcher to a bed.
To arrange client's convenience and safety.

Equipments Required

Bed sheets:
- Bottom sheet: 1
- Top sheet: 1.
Draw sheet: 1–2
Mackintosh or rubber sheet: 1–2 (according to the type of operation, the number required of mackintosh and draw sheet is different)
Blanket: 1
Hot water bag with hot water (104°F–140°F): 1 (if needed)
Tray: 1
Thermometer, stethoscope, sphygmomanometer: 1 each9
Spirit swab
Artery forceps: 1
Gauze pieces
Adhesive tape: 1
Kidney tray: 1
Trolley: 1
Intravenous (IV) stand
Client's chart
According to doctor's orders:
- Oxygen cylinder with flow meter
- Oxygen cannula or simple mask
- Suction machine with suction tube
- Airway, tongue depressor
- Electrocardiogram (ECG), SpO₂ (peripheral O₂ saturation) monitor.

Procedure

Procedure for making a postoperative bed is detailed in Table 1.3.

Table 1.3 Procedure for making postoperative bed

Sl No	Care action	Rationale
1.	Perform hand hygiene	To prevent the spread of infection
2.	Assemble equipments and bring to bedside	Organization facilitates accurate skill performance
3.	Strip bed; make foundation bed as usual with a large mackintosh and cotton draw sheet	Mackintosh prevents bottom sheet from wetting or soiled by sweat, drain or excrement Place mackintosh according to operative technique Cotton draw sheet makes the client feel dry or comfortable without touching the mackintosh directly
4.	Place top bedding as for closed bed, but do not tuck at foot	Tuck at foot may hamper the client to enter the bed from a stretcher
5.	Fold back top bedding at the foot of bed	To make the client ‘s transfer smooth
6.	Tuck the top bedding on one side only	Tucking the top bedding on one side stops the bed linens from slipping out of place
7.	On the other side, do not tuck the top sheet: Bring head and foot corners of it at the center of bed and form right angles Fold back suspending portion in one third and repeat folding top bedding twice to opposite side of bed	The open side of bed is more convenient for receiving client than the (other) closed side
8.	Remove the pillow	To maintain the airway
9.	Place a kidney tray on bedside	To receive secretion
10.	Place intravenous (IV) stand near the bed	To prepare it to hang IV soon
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11.	Check locked wheel of the bed	To prevent moving the bed accidentally, when the client is shifted from a stretcher to the bed
12.	Place hot water bags (or hot bottles) in the middle of the bed and cover with fan-folded top, if needed	Hot water bags (or hot bottles) prevent the client from taking hypothermia
13.	When the patient comes, remove hot water bags if put before	To prepare enough space for receiving the client
14.	Transfer the client: Help lifting the client on to the bed Cover the client by the top sheet and blanket immediately Tuck top bedding and miter a corner in the end of the bed	To prevent the client from chilling and/or having hypothermia

Chapter Notes

Bed MakingChapter 1